Minimally invasive parathyroidectomy (MIP) guided by preoperative sestamibi scanning has been shown to reduce operative time, hospital stay, and cost in treating primary hyperparathyroidism. However, controversy exists over routine preoperative sestamibi scanning. The purpose of this study was to determine the utility of sestamibi scanning at our institution as part of the MIP protocol and to analyze calcium and parathyroid hormone levels as possible predictors of successful sestamibi scanning. Charts of 37 consecutive patients undergoing MIP at our institution were reviewed, and age, sex, preoperative calcium, and parathyroid (PTH) levels, invasiveness of procedure, and pathologic diagnosis were recorded. Sestamibi scans were reviewed and scored by 4 nuclear medicine faculty based on the level of suspicion for parathyroid adenoma. Neither calcium nor PTH correlated significantly with sestamibi scan score (Spearman coefficient, r = 0.075, P = 0.67 and r = 0.277, P = 0.10, respectively). Receiver-operating-characteristic (ROC) analysis showed sestamibi scanning to have sensitivity and specificity in predicting MIP completion (87% and 68%). Logistic regression showed only sestamibi scan (P = 0.038), not calcium or PTH (P = 0.977 and P = 0.767) to be predictive of MIP completion. In conclusion, sestamibi scanning effectively predicted the ability to perform MIP. However, preoperative calcium and PTH predicted neither sestamibi scan results nor completion of MIP.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Results of F-choline and C-methionine positron emission tomography/computed tomography for the preoperative localization of hyperfunctional parathyroid glands in primary hyperparathyroidism.
Surgery
January 2025
Department of Endocrine Surgery, Marienhaus Klinikum Mainz, Germany.
Background: Preoperative localization of hyperfunctioning parathyroid glands in primary hyperparathyroidism is essential for successful parathyroid surgery, particularly in patients with previous negative imaging or reoperations.
Methods: A multicenter registry study was performed in 776 patients with primary hyperparathyroidism from 53 hospitals in Germany and Austria who underwent parathyroid surgery after preoperative F-choline or C-methionine positron emission tomography/computed tomography (PET/CT).
Results: In 683 of 776 patients (88%) (78% female, aged 15-86 years), primary hyperparathyroidism was caused by a single-gland parathyroid adenoma.
Diagnostic Accuracy of Four-Dimensional Computed Tomography in Preoperative Localization of Primary Hyperparathyroidism After Negative or Inconclusive Sestamibi: A Systematic Review and Meta-analysis.
J Comput Assist Tomogr
November 2024
Department of Radiology, John Radcliffe Hospital, Oxford, United Kingdom.
Objective: The aim of the study is to assess the diagnostic accuracy of 4-dimensional computed tomography (4D-CT) scans for patients with primary hyperparathyroidism (pHPT) after negative or inconclusive Technetium-99m sestamibi single-photon emission computed tomography scan.
Methods: A literature search of several databases was conducted from inception to August 2023. Eligible studies reported adult patients (>18 years old) who underwent 4D-CT after negative or inconclusive sestamibi results.
A Positive Parathyroid Washout May Obviate the Need for Nuclear Scintigraphy in Parathyroid Adenoma Localization: A Retrospective Study.
J Otolaryngol Head Neck Surg
December 2024
Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Canada.
Background: Minimally invasive parathyroidectomy (MIP) in patients with a parathyroid adenoma (PA) requires imaging modalities for precise localization. Parathyroid hormone assay on ultrasound-guided fine-needle aspiration washout, or PTH washout, can be used for this purpose. It is unclear whether PTH washout complements traditional PA localization techniques such as a sestamibi (MIBI) scan or diminishes its need.
View Article and Find Full Text PDF[F]fluorocholine PET . [Tc]sestamibi scintigraphy for detection and localization of hyperfunctioning parathyroid glands in patients with primary hyperparathyroidism: outcomes and resource efficiency.
Radiol Oncol
December 2024
Division of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Article Synopsis
- - Minimally invasive parathyroidectomy is the preferred treatment for primary hyperparathyroidism, but it relies on effective preoperative localization methods to identify overactive parathyroid tissue.
- - A study compared two groups of patients—234 who had traditional MIBI scintigraphy and 163 who had FCh-PET/CT—focusing on the efficiency and outcomes of these imaging techniques leading up to surgery.
- - Results showed that FCh-PET/CT significantly reduced imaging time by 83% and surgery time by 41% without using intraoperative hormone monitoring, suggesting it may lead to faster procedures and fewer reoperations for patients.
Sublingual glyceryl trinitrate given during adenosine sestamibi myocardial perfusion imaging causes apparent transient ischaemic dilation in a propensity-matched analysis.
Nucl Med Commun
February 2025
Department of Medical Imaging, The Prince Charles Hospital, Chermside.
Objectives: Administration of sublingual glyceryl trinitrate (GTN) prior to resting radiotracer injection during myocardial perfusion imaging (MPI) has been advocated to aid detection of viable myocardium and increase the extent of reversible perfusion defects. However, GTN is also known to reduce resting left ventricular volume and could thus increase the transient ischaemic dilation (TID) ratio, independently of severe or extensive coronary artery disease. We aimed to determine if GTN administration causes an increase in the TID ratio.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!